PROJECTSUMMARY The Healing Lodge of the Seven Nations (HL) is a Native American youth residential chemical dependency treatment center. Youth come to the Healing Lodge from tribal communities including the Coeur d?Alene Tribe, the Kootenai Tribe, the Nez Perce Tribe, the Confederated Tribes of the Colville Reservation, the Kalispel Tribe of Indians, the Spokane Tribe of Indians, and the Confederated Tribes of the Umatilla Reservation. We refer to these communities as the seven HL tribal affiliates. Recognizing the lack of programmatic research regarding best practices for supporting adolescents? recovery within tribal nations, HL has developed a research partnership with the Division on Addiction, Cambridge Health Alliance, a Harvard Medical School teaching hospital (the Division). This partnership is the Center for Indigenous Research, Collaboration, Learning, and Excellence (CIRCLE). As part of CIRCLE?s NARCH VIII program, Promoting Cultures of Recovery in Tribal Communities, we worked with and learned from these seven tribal nations. We conducted strengths and needs assessments to learn how communities seek to support their youth in recovery from substance use disorders. The proposed NARCH X program is a logical extension of this work. The proposed program will use a Tribal Participatory Program Development approach to build a mental health first response system grounded in indigenous values, strengths, and needs. We anticipate that our system of care, tentatively titled, x?a?tus (pronounced hah-toos;? i.e., First Face), will equip community members to serve as a bridge between youth in need and professional healthcare. Anyone in the tribal community will be able to use First Face to support a young person struggling with mental health problems or crises. This system will be particularly helpful for youth in recovery from substance use disorders (SUDs). Moreover, it will help prevent the development of SUDs by supporting young people who are especially at risk for SUDs due to mental health concerns. After developing this system of care, we will conduct a multi-site randomized controlled trial to test its effectiveness and revise it based on feedback from trial participants. Subsequently, we will train hundreds of tribal community members to use this innovative, culturally-appropriate, community-based mental health support system. We will secure long-term sustainability by building research and training capacity within the HL and intervention capacity within seven tribal communities.